{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T09:52:18Z","timestamp":1782294738871,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T00:00:00Z","timestamp":1621555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hyperchromatic crowded groups (HCGs) are often classified as atypical squamous cells, cannot exclude a high grade squamous intraepithelial lesion (ASC\u2010H) on ThinPrep Pap tests. This study reports on the association of HCG's with high grade squamous intraepithelial lesions (HSIL) involving endocervical glands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Over a 3\u2010year period (January 1, 2018\u2013December 31, 2020), 115 (0.2%) of 63,817 Pap tests were diagnosed as ASC\u2010H. Histologic follow\u2010up was available in 76 (66%) cases; 42 (55%) cervical biopsies; and 34 (45%) cervical cones\/LEEPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the histologic results, 49 ASC\u2010H cases showed HSIL\/CIN 3 and form the basis of this study. ThinPrep Pap tests showed two cell patterns; atypical immature squamous metaplastic cells and HCGs, each of which was difficult to distinguish from HSIL. On histologic correlation all 10 ASC\u2010H Pap Tests with individual atypical immature squamous metaplastic cells showed HSIL\/CIN 3 without endocervical gland involvement and 37 (95%) of the 39 Pap Tests with HCGs showed HSIL\/CIN 3 with endocervical gland involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study support the premise that a subset of HCGs represent endocervical gland involvement by HSIL as opposed to a glandular lesion; in particular endocervical adenocarcinoma in\u2010situ.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24805","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T14:13:40Z","timestamp":1621606420000},"page":"1008-1011","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association of atypical squamous cells, cannot exclude a high grade squamous intraepithelial lesion, hyperchromatic crowded groups and high grade squamous intraepithelial lesions involving endocervical glands"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7248-0782","authenticated-orcid":false,"given":"Suzanne M.","family":"Selvaggi","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-11074-5"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010225)93:1<16::AID-CNCR9002>3.0.CO;2-A"},{"key":"e_1_2_8_4_1","first-page":"335","article-title":"\"ASCUS, rule out HSIL\": cytologic features, histologic correlates, and human papillomavirus detection","volume":"12","author":"Sherman ME","year":"1999","journal-title":"Mod Pathol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1309\/JM3V-U4HP-W8HJ-68XV"},{"key":"e_1_2_8_6_1","first-page":"53","article-title":"Metaplastic variants of atypical squamous cells of undetermined significance: diagnosis and patient management issues","volume":"2","author":"Wilbur DC","year":"1997","journal-title":"Pathol Case Rev"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980825)84:4<208::AID-CNCR5>3.0.CO;2-I"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5858\/2006-130-332-HCGICC"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6413-4-2"},{"key":"e_1_2_8_10_1","first-page":"182","volume-title":"The Pap Test","author":"Demay RM","year":"2005"},{"key":"e_1_2_8_11_1","first-page":"605","article-title":"Atypical squamous cells: update on current concepts","volume":"23","author":"Nayar R","year":"2003","journal-title":"Clin Hub Med"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10303"},{"key":"e_1_2_8_13_1","first-page":"264","article-title":"Consequences of the introduction of combined spatula and Cytobrush sampling for cervical cytology. 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